Dana Thompson, MD, Addresses Bias and Diversity in Otolaryngology

NATIONAL HARBOR, Md.—In many ways, the change that scares so many in healthcare is a birthright for Dana M. Thompson, MD, MS.

Her grandfather, who graduated from Meharry Medical College in Nashville in 1927, was the only African-American general practitioner within a 100-mile radius of his office in Aberdeen, Miss. He was sometimes paid in chickens and eggs.

Dr. Thompson’s father was another Meharry alumni, an obstetrician in Kansas City, Kan., who only half-jokingly told people, “I’m everything the KKK hates: I’m black, Jewish, and Catholic.” He told his daughter early on that she couldn’t live her dream of being Howard Cosell of Monday Night Football fame, but instead, he brought her to his office and to the hospital to make rounds with him to show her what she could be. He instilled into her psyche that she would have to work four times harder than everyone else just to be on the same playing field.

And that little girl is now a 50-year-old, African-American woman surgeon who thrives on change.

“My presence has represented change in nearly every environment I have been in,” Dr. Thompson. “It’s required resolve and resilience. It’s required an evolving mindset from childhood messages. And it’s required mentors, sponsors, and friends.”

Her lecture, “Inspiring Change from Within: Words to Action,” was as much a heartfelt explanation of her personal journey to being an Endowed Chair and the division head of pediatric otolaryngology in the department of otolaryngology-head and neck surgery at Ann & Robert H. Lurie Children’s Hospital of Chicago as it was a prism through which to view a future for the Triological Society.

Dr. Thompson, also an otolaryngology professor with Northwestern Feinberg School of Medicine and a member of ENTtoday’s Editorial Advisory Board, wants diversity in medicine, which she said means more female and minority representation in both the society and the specialty. African Americans make up only 2.3% of all otolaryngologist residents in training, well below percentages in other specialties and the overall population. “We have to change that,” she said.

A survey of practicing African-American otolaryngologists showed that 63% are male and 52% are in academic practice. Additionally, only eight African-American otolaryngologists are division chiefs or department chairs. Dr. Thompson also wants to see more women in the field. Just 30% of otolaryngologists are female. Only 14% of the Triological Society’s members are women. Men make up 92% of the specialty’s professors (Otolaryngol Head Neck Surg. 2013;149:71–76).

In the midst of the #MeToo Movement and greater awareness of racial and ethnic bias, Dr. Thompson is ready to lead and inspire others to speak up and advocate for change—she always has been—but she’d prefer that more and more people join the charge. “Change is easier when we have an understanding of each other and appreciate our different perspectives,” she said. “It’s implicit and explicit bias that gets in the way. As an African-American woman surgeon, I’ve navigated this for 50 years. Implicit and explicit bias has been part of my reality. Whether it’s a perceived or a real obstacle, by the way, I’ve had to figure out a way to navigate around it and change course constantly and consistently.”

Change Is Constant

For those who argue that the status quo can be maintained, Dr. Thompson disagrees.

Whether it’s the “business of medicine” moving from fee-for-service reimbursement to value-based care reimbursement models where we must understand patient values (which may be very different than our own), or droves of physicians being lost to mergers of major healthcare systems and to concierge medicine, the playing field for otolaryngology is changing, and we must learn to be adaptable, said Dr. Thompson. “We’re in the 21st century,” she added. It’s a new era where change is constant.”

Take millennials, the oft-maligned generation that is a growing cohort of the otolaryngology workforce—and its next set of leaders. This generation is more comfortable with change. They were reared on technology like no generation before them, and they are more exposed to ethnic diversity and more comfortable interacting with diverse people. They also expect more work-life balance and integration than their predecessors.

That upbringing means that older physicians have to speak to them and educate them in a language they understand. Dr. Thompson calls the communicative approach the “millennial sandwich.”

“We have to search within this generational gap and give them a millennial sandwich,” she said. “So you open your conversation with praise. In the middle, you put the constructive feedback. And at the end, you put the praise and how to manage the journey to get the trophy.”

“Good Is Never Enough”

Progress won’t be easy, Dr. Thompson said, but it never has been. She recalled presenting at a Triological Society meeting in January 2000 in Cincinnati. As an early-career otolaryngologist back then, her biggest worry that cold, overcast day was supposed to be her words. But she can’t forget the KKK demonstration in the city’s Fountain Square Plaza.

And she similarly harkened back to the story of Dr. Ogura, a pioneer in larynx surgery and the namesake of her lecture. He was a Japanese American who rose to lead the otolaryngology department of Washington University in St. Louis for 16 years. “Any of us who have that journey with discrimination see that good is never enough,” she said. “And when you think that good is never enough, you’re going to push and inspire your students to reach their full potential.”

Closing with a famed quotation from Dr. Martin Luther King, Jr., Dr. Thompson urged everyone to do their part in putting aside bias and diversifying healthcare for the sake of its practitioners and its patients.

“I stand before you all, 50 years old and at the 50-year anniversary of the assassination of Martin Luther King, [Jr.],” she said. “He said,‘… of all the inequalities that exist, the injustice in healthcare is the most shocking and the most inhumane.’”

“I too have a dream, and that would be to see all the implicit and explicit biases out of medicine, so that we can collectively support each other and take care of patients in the manner and [with the] respect that they all deserve.”

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Richard Quinn is a freelance medical writer based in New Jersey.